The natural course of nicotine dependence symptoms among adolescent smokers
Open accessAbstract
INTRODUCTION: Few studies have investigated the natural course of nicotine dependence prospectively from the earliest experiences with smoking. METHODS: Drawing on a cohort of 9th- and 10th-grade adolescents followed over 48 months, survival analyses were conducted to evaluate the cumulative probability, following smoking initiation, for the development of nicotine dependence symptoms. RESULTS: Although each nicotine dependence symptom was significantly more prevalent among adolescents who had smoked more than 100 cigarettes by the end of the follow-up assessment, 20% of adolescents smoking fewer than 100 cigarettes reported experiencing "smoking to relieve restlessness and irritability" and "smoking a lot more now to be satisfied compared to when first smoked." Nicotine dependence symptoms were also reported before reaching 100 cigarettes for a substantial number of adolescents (between 9.4% and 58.8% for individual symptoms). Endorsement of nicotine dependence symptoms prospectively predicted past-week smoking (odds ratios [ORs] between 3.18 and 14.62 for significant symptoms) and past-month daily smoking (significant symptoms' ORs between 3.52 and 10.68) at the 48-month assessment even when controlling for amount of previous smoking. CONCLUSIONS: The present study adds to the growing body of literature on the natural course of nicotine dependence from earliest experiences with smoking by showing that symptoms of nicotine dependence may develop soon after initiation and/or at low levels of smoking. Our findings suggest that novice adolescent smokers should not be neglected in smoking cessation intervention and that screening and effective intervention for early emerging symptoms among adolescent smokers may be an important target in preventing chronic smoking.
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Some clinical studies of tobacco cessation in teenagers indicate that they may be especially sensitive to withdrawal, showing dependence symptoms soon after smoking initiation and before daily smoking habits are established.
“Some clinical studies of cessation of tobacco use in teenagers indicate that they may be especially sensitive to withdrawal, exhibiting symptoms of dependence soon after smoking initiation and before the establishment of daily smoking habits (DiFranza et al., 2007; Dierker & Mermelstein, 2010; Zhan et al., 2012).”
From Unique, long-term effects of nicotine on adolescent brain. (2020) · cites this paper as Zhan et al., 2012
The results (p. 4) report dependence symptoms, including smoking to relieve restlessness and irritability, before daily smoking in some adolescents. The paper’s summary also says symptoms can develop soon after initiation. However, this is a prospective study of smoking and dependence, not a clinical cessation study, and it does not establish that teenagers are especially sensitive to withdrawal relative to another group. (LLM, conf=0.86)
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- Authors
- Zhan, W., Dierker, L. C., Rose, J. S., Selya, A., & Mermelstein, R. J.
- Affiliations
- Wesleyan University (US)
- University of Illinois Chicago (US)
- Venue
- Nicotine & Tobacco Research
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-03-15
- Volume
- 14
- Issue
- 12
- Pages
- 1445-1452
- ISSN
- 1462-2203 (ISSN-L)
- 1469-994X
- PMC
- PMC3509011
- OpenAlex
- W2050654135
- Cited by
- 49
- References
- 39
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 4 · 2022: 1 · 2021: 2 · 2020: 8 · 2019: 3 · 2018: 3 · 2017: 5 · 2016: 4 · 2015: 4 · 2014: 8 · 2013: 2
- FWCI
- 3.00
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Nicotine & Tobacco Research (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- University of Pennsylvania
- Pennsylvania State University
- National Institute on Drug Abuse (DA010075, DA022313 -S, DA022313, DA029834, P50DA010075, R21DA029834, R01DA022313)
- National Cancer Institute (P01CA098262, CA098262)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Nicotinic Acetylcholine Receptors Study
- Keywords
- nicotine dependence, adolescent smoking, smoking initiation, daily smoking, smoking cessation interventions, smoking screening, nicotine withdrawal symptoms
- MeSH terms
- Smoking Prevention, Adolescent, Adolescent Behavior, Chicago, Female, Humans, Longitudinal Studies, Male, Smoking, Tobacco Use Disorder, Cohort Studies
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